Abstract:

Objective： To investigate the anesthetic choice for patients undergoing cesarean section complicated with placenta implantation. Methods: A retrospective case review of the patients with placenta implantation between 2008 and 2013 at Peking University Third Hospital was conducted in the International Classification of Diseases (ICD)-9 codes, excluding natural birth and not first diagnosed in our hospital, a total of 96 cases were incorporated into this study. According to the degree of implantation, they were divided into three groups: accreta group, increta group and percreta group. We analyzed the time from the start of surgery to baby delivery and the anesthetic technique. Results: The accreta group included 49 cases, the increta group 33 cases, and the percreta group 14 cases. The average time from the start of surgery to fetus delivery in the three groups were (6.7±3.0) min, (7.2±4.6) min, and (11.9±4.9) min, and the percreta group was significantly different from the accreta group and the increta group (P<0.05). There were significant differences among the three groups in anesthetic choices (P<0.001): in the accreta group, 45 cases (91.8%) underwent spinal anesthesia, 2 cases (4.1%) underwent general anesthesia, and 2 cases (4.1%) were converted to general anesthesia after spinal anesthesia during the operation; in the increta group, 22 cases (66.7%) underwent spinal anesthesia, 4 cases (12.1%) underwent general anesthesia, and 7 cases(21.2%) were converted to general anesthesia after spinal anesthesia; in the percreta group, 2 cases (14.3%) underwent spinal anesthesia, 2 cases (14.3%) underwent general anesthesia, and 10 cases (71.4%) were converted to general anesthesia after spinal anesthesia. Conclusion: Spinal anesthesia can be used as the first choice of cesarean section complicated with placenta implantation and general anesthesia should be considered in placenta percreta.

Key words: Placenta implantation, Cesarean section, Anesthesia